Individual provider Active NPI

Kylee Mae Lucchese, NP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1588339253
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
262302 Issued in AZ
Practice address
4540 E Baseline Rd Ste 114
Mesa, AZ 85206-4617
Phone
(480) 497-2229
Fax
(480) 699-5681
NPI assigned
Aug 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 262302 AZ Primary

Addresses

Primary practice location

4540 E Baseline Rd Ste 114
Mesa, AZ 85206-4617

Mailing address

PO Box 748860
Atlanta, GA 30374-8860
Phone (480) 497-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000980 AZ Practitioner - Nurse Practitioner 0345637278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women's Care Arizona, LLCGroup PAC ID 6103215322, 36 clinicians

Practice addresses (Care Compare)

4915 E Baseline Rd
Suite 126
Gilbert, AZ 85234-2969
Phone (480) 969-3096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
262302AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Arizona, LLC CurrentSince Mar 17, 2022 Accepting new patients

Locations

10815 W McDowell Rd
Ste 301
Avondale, AZ 85392
Phone (623) 433-0106

4915 E Baseline Rd
Ste 126
Gilbert, AZ 85234
Phone (480) 745-3690

4540 E Baseline Rd
Ste 114
Mesa, AZ 85206
Phone (480) 497-2229

Interoperability endpoints

  • Direct secure messaging: kylee.lucchese@wcfnf.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1588339253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748860",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748860",
            "telephone_number": "480-497-2229",
            "fax_number": "480-699-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064617",
            "telephone_number": "480-497-2229",
            "fax_number": "480-699-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCCHESE",
        "first_name": "KYLEE",
        "middle_name": "MAE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "262302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.